【摘要】 目的评价标准化尘螨变应原疫苗皮下免疫疗法(subcutaneous immunotherapy,SCIT)和舌下免疫疗法(sublingual immunotherapy,SLIT)治疗中-重度特应性皮炎(atopic dermatitis,AD)的临床疗效和安全性。方法 150例中-重度AD患者分为两组,分别采用SCIT和SLIT的免疫治疗方案。随访6个月~2年,观察免疫治疗过程中的局部和全身不良反应发生情况,所有患者在治疗结束后均进行AD评分(scoring atopic dermatitis index,SCORAD)和有效率的评价。结果临床疗效判断,两组相比差异有统计学意义(P<0.05)。两组治疗前后血清s Ig E比较差异无统计学意义(P> 0.05)。SCIT组所有患者在免疫治疗的不同阶段均出现局部反应,SLIT组有4例(5.5%)出现局部反应,两组患者的局部不良反应均较轻微,可耐受并自行缓解。两组全身不良反应的发生率差异无统计学意义(χ~2=0.0038,P> 0.05)。结论尘螨过敏的AD患者采用皮下注射或舌下含服途径进行特异性免疫治疗均有良好的临床疗效,两组有效率相比差异无统计学意义,两种治疗方式的全身不良反应发生率无明显差异,但局部不良反应发生率SCIT高于SLIT,差异有统计学意义。更多还原

【Abstract】 Objective To investigate the efficacy and safety of subcutaneous immunotberapy(SCIT) versus sublingual immunotherapy(SLIT) in patients with atopic dermatitis(AD). Methods A total of 150 patients with AD were enrolled in this study and received either SCIT or SLIT. Local and systemic reactions were carefully recorded and analyzed during the immunotherapy schedules(followed up for 6 months to 2 years). Scoring atopic dermatitis index(SCORAD) and effective rates were observed after the end of treatment. Results Clinical efficacy: before and after the treatment, rash integration and SCORAD between the two groups had no significant difference(P>0.05), pruritus integration in the SCIT group(2.12±1.08) remarkably lower than the SLIT group(4.42±1.51) after the treatment(P<0.05). There was no significant difference between the two groups in effective rates(53.25% vs 52.05%, P>0.05). The level of serum IgE had no significant difference between the two groups(P>0.05). Local swelling commonly occurred following injections throughout the treatment duration in the SCIT group, and oral itching associated with drop intakes was reported by 4 subjects(5.5%) in the SLIT group. All local reactions were mild, well tolerated and self-limiting in both groups. The systemic reactions were mild or moderate and no significant difference in the overall incidence of systemic adverse effects was found between the SCIT and SLIT groups(11.69% vs10.96%, χ~2=0.0038, P>0.05). Conclusion The clinical effects and systemic adverse reactions of SCIT are not significantly different from SLIT in patients with AD caused by house dust mites. However, the incidence of local adverse reactions of SCIT is higher than SLIT.更多还原